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1、子宮托治療盆腔器官脫垂的臨床研究摘要目的:研究子宮托在盆腔器官脫垂患者屮的應用及療效。方法:2008年1月-2010年12月,對55例符合入組標準的、并愿意佩戴了宮托治療的盆腔器官脫垂患者進行治療,并隨訪觀察,應用生活質量調查問卷(PFDI-20短表)評佔治療前后患者癥狀和?;钯|量影響,并對影響子宮托治療成功與否的相關因素進行臨床分析。結果:55例患者平均年齡64.4歲,按照POP-Q分度,II度9例,III度33例,IV度13例,隨訪時間3天?26個月。3天子宮托佩戴率為83.6%(46/55),1個月為78.2
2、%(43/55),3個月為60.0%(33/55)。治療成功組與失敗組在年齡、體重指數(shù)、陰道總長、生殖裂孔、盆腔脫垂部位、POP-Q分度、子宮托類型差異無統(tǒng)計學意義(P>0.05)o與失敗組相比,成功組的患者絕經年數(shù)更少(16.22±9.19vs24.00±10.14,p<0.05),病程更短(7.35土&64vs15.58±12.06,p<0.05),產次更少(3.69±1.67vs3.79±l?36,p<0.05),會陰體更長(3.63±1.05vs2.13±1.51,p<0.05)。成功組的PFDI-20短表
3、總評分、POPDI?6(盆腔器官脫垂)評分、CARDI-8(腸道脫垂)評分和UDI-6(排尿癥狀相關癥狀)評分由治療前分別為(119.54±39.30)分、(13.96±4.46)分、(10.04±4.26)分、0.19±3.03)分下降至1月垢(57.41i21.07)分、3.44±1.65)分、(6.81±2.42)分、(5.22±2.33)分,差異冇統(tǒng)計學意義。治療后1個月、3個月比較沒有差異。結論:子宮托能有效緩解POP患者陰道或盆腔、排尿及排便困擾癥狀,顯著改善患者生活質量,是盆腔器官脫垂患者可首先考慮的
4、治療方法。了宮托放置成功與否與會陰體長度、產次、病程、絕經年數(shù)有關,與POP-Q分度、了宮托類型無關。【關鍵詞】子宮托盆腔器官脫垂PFDI-20治療效果TheclinicalstudyaboutpessarytreatmentforwomenwithpelvicorganprolapseAbstractObjectivezToprobetheeffectivenessofpessarytreatmentforwomenwithpelvicorganprolapscd(POP),andanalyzefactorswh
5、ichinfluencethethesuccessoftreatment.Methods:BetweenJanuary2008andDecember2010,55POPpatientswhointerestedinpessarytreatmentandfulfilledtheinclusioncriteriareceivedtheimplementationofpessary.TheywererequiredtocompletethePelvicFloorDistressInvcntory-20(PFDI-20)b
6、eforeandafterimplementationofpessaryin1month,3monthsforevaluation.Results:Theaverageageofall55patientenrolledwas64.4years.NinepatientswasstageII,33casesstageIII,and13stageIVaccordingtothePelvicOrganProlapseQuantification(POP-Q)system,theywerefollowedupforfrom3
7、daysto26months.Thesuccessfulratesofsatisfactorypessaryfittingover3days,1monthsand3monthswere83.6%(46/55),78.2%(43/55)and60.0%(33/55)respectively.Therewasnosignificantdiflerenceinage,bodymassindex(BMI),totalvaginallength,genitalhiatus,POP-Qstage,predominatcompa
8、rtmentofprolapse,andpessarytypebetweensuccessfulgroupandfailuregroup.Comparedtofailuregroup,thereweresignificantdifferenceinyearsafterpostmenoposal(16.22±9?19vs24.00±10?14,p<0.05),